Saliva Dysfunction and Oral Microbial Changes among Systemic Lupus Erythematosus Patients with Dental Caries

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune and inflammatory disease affecting multiorgans of human body. Independent studies show that SLE patients had higher caries prevalence compared to non-SLE individuals. However, the underlying mechanisms remain unclear. In present study, we enrolled SLE patients to explore potential factors contributing to the susceptibility of SLE patients to dental caries (such as oral hygiene, salivary function, and oral microbial community). Dental examination confirmed SLE patients were more vulnerable to caries. Although subjects in both groups announced similar oral hygiene habits, more dental plaque was found on tooth surfaces of SLE patents as revealed by plaque index. In addition, the salivary function was impaired in SLE group as salivary flow rate, buffering capacity, and pH were lower among SLE subjects compared to healthy controls. Importantly, disturbed microbial community with lower richness and diversity was observed in SLE group, as well as disequilibrium between acidogenic/aciduric pathogens and alkali-generating commensal bacteria. Our data suggest that SLE increases patients' sensitivity to dental caries through imposing stress to both host and oral microbes.

Oral Hygiene and Dental Caries Status on Systemic Lupus Erythematosus Patients: A Cross-Sectional Study

“…A previous study found poor oral hygiene as a result of abnormalities in immune response in SLE patients [6]. Autoantibodies are resulting in oral bacteria changing, and biofilm with virulence microbe forming, such as dominant streptococcus mutants and porphyromonas gingivalis finding [12].…”

“…SLE patients had dental disease incidence reported 60-93% worldwide, higher than healthy patients with no systemic disease [7]. Oral manifestations have been found frequently in SLE patients, including recurrent infections or mouth ulcers, severe gingivitis, temporomandibular joint disorder, osteonecrosis of the mandible, hyposalivation (decrease of salivary flow), and excessive dental caries [12]. A previous study found poor oral hygiene as a result of abnormalities in immune response in SLE patients [6].…”

“…Summation was done to obtain the results DMFT, and also to found out the DMFT average value. DMFT index criteria were categorized as very low in the value of 0.0-1.1; low in the value of 1.2-2.6; moderate in the value of 2.7-4.4; high in the value of 4.5-6.5; and very high in the value above 6.6 [12,17].…”

“…These four bacteria accumulated in SLE and could change the pH drop caused by organic acid produced [12].…”

“…The degree of decrease in pH depends on the thickness of the plaque, the number and combination of bacteria contained in plaque, as well as the efficiency of the ability of salivary buffer. SLE patients also had xerostomia conditions and could affect the efficiency of the ability of salivary buffer [12][13][14]. This condition could affect dental health resulting in poor oral hygiene and a high number of dental caries.…”